Elderly, frail people are more likely to be hospitalized if they are receiving home- or community-based services than if they live in a nursing home, according to newly published research. Recent Medicaid reforms have aimed to increase use of HCBS because it is believed to be less costly than institutional long-term care, investigators noted. They said their findings suggest that more frequent hospitalizations are a "hidden cost" of home- and community-based care.
A whistleblower exposed disturbing drug packaging practices being used by long-term care pharmacy Omnicare Inc., but the charges don't fall under the False Claims Act, a federal appeals court recently ruled.
The federal government has joined in a whistleblower lawsuit alleging that a large hospitalist company engaged in systematic "upcoding" of Medicare and Medicaid claims.
An Illinois-based hospice provider overbilled Medicare and Medicaid by inappropriately designating nursing home residents as hospice patients, sometimes for years, according to federal charges announced Monday. The hospice administrator also took money for his personal accounts and obstructed justice, the prosecutors claim.
Two nursing home therapy providers and a nursing home management company have agreed to pay $30 million to settle claims that they engaged in a kickback scheme, the U.S. Department of Justice has announced.
What the long-term care insurance market could use right now is a healthy dose of capitalism. But it isn't going to happen.
Providers and long-term care advocates need to embrace Medicaid managed care systems, which have the potential to drive improved health outcomes and bottom lines while helping providers serve those most in need, according to LeadingAge President and CEO Larry Minnix.
Long-term care providers will feel some effects but should not experience serious disruptions due to the shutdown of the federal government, according to prominent trade associations.
The Congressional Commission on Long-Term Care convened for its third hearing last week, focusing on how Medicare, Medicaid and long-term care insurance interact, and potential ways to strengthen these payment mechanisms. Over roughly eight hours, the 15 commission members heard from a total of 15 subject matter experts on four separate panels.
The second round of the Health Care Innovation Awards is now underway, the Centers for Medicare & Medicaid Services announced Wednesday. CMS will distribute up to $1 billion to fund projects that aim to improve care while cutting costs for the Medicare and Medicaid programs.
Long-term care providers who self-disclose potential Medicare and Medicaid fraud will likely benefit from lower repayment amounts, according to updated guidance released Wednesday. It is the first time HHS has explicitly acknowledged systematically imposing lower penalties for self-reported fraud.
The Centers for Medicare & Medicaid Services and the state of Illinois are teaming up in a dual eligible payment demonstration.
The House Budget Committee approved the latest spending plan from Chairman Paul Ryan (R-WI) in March. The vote was 22 to 17 along party lines.
Medicare and Medicaid should not be significantly altered, because spending for these programs is trending downward and incentives tied to the programs are working, according to Health and Human Services Secretary Kathleen Sebelius.
A False Claims Act lawsuit involving a nursing home chain and therapy providers in Missouri can move forward, a federal judge has ruled. The case originated when a whistleblower alleged that a therapy company received more than $10 million in kickbacks as part of a scheme to overbill Medicare and Medicaid.
The co-chairs of President Barack Obama's deficit reduction commission are promoting a way to achieve $600 billion in healthcare "savings" in a new version of their deficit reduction plan. Medicare and Medicaid cuts would be targeted over the next 10 years.